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Organization

REGIS LEGACY LLC

Active
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Organization

REGIS LEGACY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. OLUWASEGUN ISAAC OLUDIRAN (PRESIDENT)
(832) 613-4377
Entity
Organization

Contact information

Practice address
21310 PLUM GATE CT, RICHMOND, TX 77407-1425
(832) 613-4377
Mailing address
21310 PLUM GATE CT, RICHMOND, TX 77407-1425
(832) 613-4377

Taxonomy

Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
320800000X
Mental Illness Community Based Residential Treatment Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other

Enumeration date
08/15/2024
Last updated
10/14/2024
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